How CMS calculates hospital star ratings

For this year's ratings, CMS analyzed 45 hospital quality measures across five different groups:

• Mortality (22%)
• Safety of care (22%)
• Readmission (22%)
• Patient experience (22%)
• Timely and effective care (12%)

All percentage weights are out of 100%. If a hospital had no measures in a certain measure group, the weighted percentage was redistributed proportionally across the other measure groups. Depending on the measure, CMS used hospital data collected from July 2020 to December 2024 for its latest rankings.

This year, CMS added a new inpatient measure (the hybrid hospital-wide all-cause risk standardized mortality rate) and updated two other measures on the hybrid hospital-wide all-cause readmission rate and pre- and post-operative assessment response rates for hip/knee replacement patients. Four payment measures for acute myocardial infarction, heart failure, pneumonia, and elective primary total hip arthroplasty/total knee arthroplasty replacement were also removed.

How hospitals performed

According to CMS, a majority of hospitals (63%) received a Star Rating this year. Overall, 44 more hospitals received a rating in 2025 (2,891) compared to 2024 (2,847). Although most hospitals (2,771) received a rating in both 2024 and 2025, 76 hospitals no longer met the reporting threshold. An additional 120 hospitals newly met the reporting threshold in 2025.

Of the 2,891 hospitals that received a rating:

• 291 received a five-star rating (10.1%)
• 767 received a four-star rating (26.5%)
• 939 received a three-star rating (32.5%)
• 661 received a two-star rating (22.9%)
• 233 received a one-star rating (8.1%)

Changes to the ratings over time

This year, 90 fewer hospitals received a five-star rating (381 in 2024 compared to 291 in 2025). At the same time, there was a slight decrease in the number of hospitals with one-star ratings (277 in 2024 compared to 233 in 2025).

In general, there has been a downward trend in hospitals receiving five-star ratings over the last few years. Fewer than 300 hospitals received five-star ratings this year compared to around 400 or higher in previous years.  

Last year, Rick Kes, a healthcare senior analyst at consultancy RSM, said that it was surprising that hospitals' Star Ratings have continued to trend downward despite facilities having taken steps to improve the patient experience and care quality since the start of the pandemic.

However, Kes also noted that data for the ratings were collected from several different time periods of the pandemic, and some hospitals may have been struggling with finances, staffing, and high patient acuity at the time.